A case report of dysphagia and cervical muscle weakness along with predominant bulbar palsy as the initial presentation of systemic lupus erythematosus

Mazdeh, M. and Khazaei, M. (2014) A case report of dysphagia and cervical muscle weakness along with predominant bulbar palsy as the initial presentation of systemic lupus erythematosus. Feyz Journal of Kashan University of Medical Sciences, 18.

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Official URL: http://feyz.kaums.ac.ir/article-1-2389-en.html
DOI: UNSPECIFIED

Abstract

Background: Neuropsychiatric disorders are among the known complications of systemic lupus erythematosus (SLE). The involvement of both peripheral and central nervous systems has also been reported in SLE.Case Report: A 32 year-old woman presented with 15 days history of progressive dysphagia, the nasal intonation of voice with no significant previous medical illness. The neurologic examination showed a marked bulbar (involvement of 9, 10, 11 cranial nerves) and cervical palsy. Other systemic examinations were normal. Hematologic tests, ESR, CRP, renal and hepatic tests and a chest x-ray PA were normal. Moreover, the CSF analysis and electrophysiological studies (EMG, NCV) were normal. The ANA and Anti-ds DNA tests were positive for two consecutive times. Brain MRI revealed infarct lesions in RT cerebellar hemisphere and dorsal brainstem. A diagnosis of vasculitis secondary to liked-lupus was made based on laboratory tests and imaging. Then intravenous immunoglobulins (0.4 g/kg/day) and 0.5 g methyl prednisolone for 5 days were administered. She was discharged for the rheumatologic follow-up. Conclusion: It can be concluded that SLE should be considered in any patient with obscure neurological problems.

Item Type: Article
Subjects: Medicine
Divisions: Feyz journal
Depositing User: ART . editor
Date Deposited: 07 May 2017 16:47
Last Modified: 03 Jun 2017 12:31
URI: http://eprints.kaums.ac.ir/id/eprint/1602

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